Resources for ADHD
What is ADHD? Can We Help?
ADHD is the most commonly diagnosed behavioral condition in children today. ADHD is a real and treatable neurodevelopmental condition that affects almost 9% of children in the United States. All children will have behavioral problems once in awhile; but for children with ADHD and their families, the challenges are much more daunting and persistent, and make it difficult to succeed in their daily lives.
ADHD symptoms fall into 3 basic subtypes, which include inattentive, hyperactive/impulsive behavior, and a combination of both. The symptoms of inattention may include great difficulty in paying attention in school, finishing tasks, or following directions. A child with another sub-type of ADHD may have a hard time controlling their impulses, and sitting still, as well as interrupting, talking in class, and blurting out answers or remarks. Any type of ADHD can affect your child at school, at home, and at play. Your child may not know how to interact well with other children and end up feeling isolated.
ADHD is not a reflection of a child's intelligence or their potential, nor is it a result of poor parenting or spoiled children. ADHD is a biological condition that affects certain types of brain functioning. There are differences in key areas of the brain with ADHD as well as in chemical messengers, or neurotransmitters, in the brain. These messengers play a role in behaviors like attention and movement. Recent brain research has shown that people with this condition have less of these critical substances in specific areas of their brain, as well as actual structural differences that may account for their symptoms.
Because of its biological nature, ADHD can be inherited much like other conditions such as sickle cell disease or diabetes. Studies suggest that more than 3/4 of ADHD is linked to family genetics, and is therefore more common amongst people who have a close relative with ADHD.
If you think your child may have ADHD, speak with your child’s primary care physician. It is essential to take the time to evaluate a child carefully, and to gather information from more than one source when considering the diagnosis of ADHD. There is no blood test or radiology test at this point which can detect ADHD; it is therefore said to be a clinical diagnosis. The standard of care in this area of medicine includes a thorough medical and educational history, a family history, developmental history, and a comprehensive physical examination. Using evidence based medicine, including valid clinical tools and assessments to assist in making the diagnosis, is critical. Many children who have ADHD also have other conditions, such as a learning disorder, depression or anxiety. Evaluating children therefore in a setting where comprehensive services can be provided by specialists is very valuable, as is providing multi-faceted treatment plans. A professional dedicated to diagnosing and managing these types of issues frequently is the best approach for comprehensive care.
While there's no cure for ADHD, the symptoms of the condition can be effectively treated. Multifaceted treatment plans have been shown to be the most effective for many developmental disorders, including ADHD. Therapeutic services in the school and community settings, appropriate behavior management, Psycho-therapies, such as cognitive behavioral therapy, as well as medication may all have a role. Select complementary and alternative therapies may be helpful for some patients, and the ‘common sense’ triad of a good night’s sleep, a healthy diet and regular exercise are also essential to maximize functioning. Outcomes data shows that the most effective treatment plans include behavioral management plans and therapy, educational interventions (such as 504 Plans, Individualized Education Plans or Student Support Plans), in combination with prescription medication prescribed by a physician. Treatment has been shown to improve children’s focus at school, in the community and at home. It can also improve their social interactions with peers and family members. It elevates their self-esteem, and sets them on a path for success. Treatment can facilitate closing gaps in learning in both reading and math as opposed to controls. It results in better outcomes: high school graduation, college attendance and graduation, less police involvement, fewer motor vehicle accidents for drivers, lower use of ‘self-medication’ through marijuana or alcohol, and lower rate of substance abuse. Moreover, there is strong emerging evidence that treatment improves the underlying neurodevelopmental differences between ADHD children and their Neurotypical peers more quickly than controls.
Could your child have ADHD?
If you answer ‘yes’ to more than 5 of the following questions about yourself or your child, you should consider having an evaluation for an Attention Disorder.
_____ Often easily distracted especially during tasks such as school work
_____ Often acts impulsively, ie interrupts or has difficulty sitting still
_____ Often has difficulty stopping activities or behavior when he/ she should
_____ Often starts a project or task without reading or listening to directions carefully
_____ Often shows poor follow-through on projects or commitments made to others
_____Often has trouble doing things in their proper order or has poor time management
_____ Often has difficulty sustaining attention or daydreams
_____ Often has difficulty organizing homework, tasks or activities
And, these symptoms have been present for a sustained period of time and are not better accounted for by another serious disorder such as major depression, anxiety, recent traumatic events or major family changes.
Organizations which provide education, advocacy, and support for parents and adults with ADHD:
*CHADD (Children and Adults with Attention Deficit/Hyperactivity Disorder) www.chadd.org
*National Resource Center on ADHD www.help4adhd.org
*ADDA (Attention Deficit Disorder Association) www.add.org
*American Academy of Pediatrics www.aap.org
*American Academy of Child and Adolescent Psychiatry www.aacap.com
*CACLD (The Connecticut Association for Children with Learning Disabilities) www.cacld.org
Books and Other Readings
The following resources might be helpful for school age children with ADHD:
The following resources might be helpful for younger students:
*Sparky’s Excellent Misadventures, by Phillis Carpenter and Marti Ford
*Eukee the Jumpy, Jumpy Elephant, by Clifford Corman, M. Trevino, and Esther Trevino
*Otto Learns About His Medicine: A Story About Medicine for Children with ADHD, by Matthew Galvin
*Shelley, the Hyperactive Turtle, by D. Moss
*Attention Girls!, by Patricia Quinn, MD
*Putting on the Brakes, by Patricia Quinn, MD and Judith Stern
*A Bird’s-Eye View of Life with ADD and ADHD: Advice from Young Survivors!, by Alex Zeigler and Chris Zeigler Dendy
*Learning to Slow Down and Pay Attention, by Kathleen Nadeau PhD and Ellen Dixon PhD
*How to Do Homework Without Throwing Up, by Trevor Romain
The following resources might be helpful for parents of children with ADHD:
*ADHD: What Every Parent Needs to Know, by Eddie Reiff, MD
*ADD/ADHD: A Parent’s Practical Guide to Attention Deficit Disorders, by Marie Annette Isom
*ADD from A to Z: A Comprehensive Guide to Attention Deficit Disorder, by Phillip McLaughlin and William Bender
*Smart but Scattered: The Revolutionary “Executive Skills” Approach to Helping Kids Reach Their Potential, by Peg Dawson, EdD and Richard Guare, PhD
*How to Reach and Teach Children with ADD/ADHD, by Sandra Rief
*Raising Your Spirited Child, by Mary Sheedy Kurcinka
*Driven to Distraction, by Edward Hallowell, MD and John Ratey, MD
*Taking Charge of ADHD, by Russell Barkley, PhD
*Spark: The Revolutionary New Science of Exercise and the Brain, by John Ratey, MD
Resources that can be helpful for Social Skills:
*Socially Curious and Curiously Social: A Social Thinking Guidebook for Teens & Young Adults with Asperger’s, ADHD, PDD-NOS, NVLD, or other Murky Undiagnosed Social Learning Issues by Michelle Garcia Winner and Pamela Crooke.
*Teaching Your Child the Language of Social Success by Marshall P. Duke, Stephen Nowicki, and Elisabeth A. Martin may help bolster interpersonal awareness of self and others through training in discrete exercises.
*www.socialthinking.com for books and curriculum by Michelle Garcia Winner
*The Hidden Curriculum- Unwritten Rules that Students with Disabilities Often Miss by Brenda Myles, Ph.D.
Managing ADHD at Home
Difficulty with Listening
Children who have ADHD often have difficulty with ‘listening’. They tend to be visual learners and retain more information that way. As they are easily distracted, verbal instructions that are complex, unclear or come with multiple steps are problematic for them. To maximize your child’s success and minimize your frustration, try some of the concrete suggestions below to improve things.
*Before giving instructions, turn off the things that compete with you for your child’s attention. These include TV, loud music, or video games.
*Make sure you have your child’s attention. You can do this by being face-to-face and making eye contact. Use touch or visual signs if it helps your child make a connection.
*Write down instructions as needed. List directions step by step, and use pictures if it helps.
*Provide instructions one step at a time. Wait for the first step to be completed before moving to the next one.
*Focus on what you want your child to do and phrase your instructions in a positive way.
*Be as clear as possible.
*Avoid unneeded discussion; keep instructions brief and to the point.
*Ask your child to repeat directions in his or her own words before starting a task.
*Show your child what you want him or her to do. Walk through the steps yourself and then with your child.
*Spend time teaching your child how to listen without interrupting. You can practice listening together. Use gentle warnings when your child interrupts, and state calmly what the rule is. Praise your child for good behavior.
Extra energy/Hyperactivity& Impulsivity
Many children with ADHD have extra energy which causes them to feel the need to move and use their bodies.
*Fidgeting is not always a problem and may even help some children with ADHD focus. If fidgeting becomes distracting, try a “fidget toy.” This could be a stress ball, a pipe cleaner, worry beads, or another quiet, handheld object. Having something to hold in his or her hands may help your child stay calm and sit still.
*Learning how to relax and be calm can be a good thing for children who are hyperactive. Teach your child relaxation techniques. Show him or her how to take several deep breaths while counting slowly to 10.
*Switch between “seated” activities and ones that let your child move around. It may also be helpful to let your child stand while doing homework or other “seated” activities.
*Children with ADHD can benefit from finding good ways to direct their energy. Hobbies such as drama, dance, or taking pictures can help your child be creative. Activities such as drawing, building models, or working with clay can keep hands busy.
Children with ADHD are often on the go---both literally and in their own head. Things are busy in their brain, and often things occur to them suddenly that they feel they just have to get out or act upon. They truly have a harder time engaging the ‘thinking’ part of their brain to put on the brakes! This feature of ADHD is called impulsivity, and can manifest as talking out in class, grabbing the last cookie, or pushing their brother out of the way to get to the swing first. They can be misunderstood and are often accused of being selfish, bossy, or difficult to get along with. Weaknesses in social skills are common in children with ADHD, as they have a more difficult time taking someone else’s perspective, and think that everyone see’s things as they do. A bumper sticker I saw sums it up perfectly: “I’m not BOSSY, my ideas are just better!”
*Teach your child about ‘good’ and ‘bad’ behaviors, but try to minimize use of those words and NEVER use those words to describe the child. Emphasize that their choice, or the behavior, was undesirable and offer a better solution. Use gentle warnings when your child interrupts, and state calmly what the rule is. Praise your child for good behavior.
*Children with ADHD may have a hard time waiting their turn. Turn taking is expected in many areas of life. This includes at home, in school, and in social settings. Let your child know what you expect about turn taking. Give praise or other rewards when you see your child waiting his or her turn.
*Show your child how to be patient in social settings. Do not interrupt mid-sentence or talk over others. Be sure to use respectful language, tone of voice, and body language.
*Encourage your child to use self-talk, such as “Stop and think,” or “I need to wait until she’s finished before I answer,” or “I need to raise my hand.”
Difficulty with Organizing
Because children and teens with ADHD tend to be visual learners, they often remember to perform chores, tasks etc. if they have a visual reminder such as a white board. As these kids often have difficulty with initiating ‘work’ of any kind, a visual list or chart can be very helpful to remind them what needs to get done. As most of these children have deficiencies with organization as well, visual schedules can be very helpful for them and the whole family in this regard as well. To maximize your child’s success and minimize your frustration, try some of the concrete suggestions below to improve things.
*Children with ADHD often do better with a set schedule. Hang up a chart that shows the tasks your child needs to complete. You can make a weekly chart that shows homework time, after-school activities, dinnertime, etc. You can also post a daily chart with more details. For example, you could list: complete 5 math problems, take a 5-minute break, finish math, write out spelling words, and so on.
*You may want to hang a family calendar that lists chores and activities. Try to encourage everyone to use it.
*If your child is looking forward to an enjoyable activity, have him or her finish a less enjoyable activity first. We call this alternating ‘preferred’ and ‘non-preferred’ tasks.
*Help your child pace himself or herself. Provide feedback and praise for each step completed.
*When you check your child’s work, have him or her correct any errors you find. If you see that chores are unfinished or sloppy, have your child redo them.
*When the work is corrected or the chores are done right, let your child know he or she did a great job.
*It may help to use a reward system that gives positive reinforcement each time your child follows through on a tough task. Offer an activity that he or she likes, such as more TV time or going out to eat. Talk about rewards and ask your child to make suggestions of his or her own. Giving them a choice always helps to motivate them and gives them the illusion of control.
*Do not agree to rewards that disrupt your child’s daily routine. If the rule is no computer before homework, do not offer computer time before homework as a reward.
*Create a sense of order for your child by helping to organize his or her room. At first you may need to work with your child to get started. Once things are in place, it is important for the child to keep it up on his or her own.
*If your child tends to forget items for the next school day, help him or her prepare the night before. Depending on your child’s age and maturity level, pack his or her book bag or encourage him or her to do so.
*If your child uses a cell phone or smartphone, consider using the calendar, alarm, or timer to set reminders. If your child uses e-mail, he or she might want to send e-mail reminders to himself or herself. Reminders might include after-school activities, homework, due dates for library books, or even a reminder to call home.
*With your child, set a start time for a task such as a homework assignment, reading a book chapter, or cleaning his or her bedroom. Talk with your child about how long it should take to finish. Stay with your child until he or she gets started. Check back now and then to make sure he or she is still working.
Medication Guide and Other Articles
You can download the ADHD medication guide provided by the American Psychiatric Association by clicking here.
National Institute of Health (NIH), Health & Human Service; ADHD
Center for Disease Prevention and Control